Friday, May 30, 2008

State orders Wilmington detoxification facility to suspend operations

State officials have ordered a Wilmington facility that treats mental health emergencies and substance abusers to suspend its operations, calling conditions there detrimental to the health and safety of patients.

Southeastern Center for Mental Health, which operates the center, also faces $13,500 in penalties in connection with a number of alleged violations centering around the death of a 27-year-old woman late last year.

The woman, who is not named in the state report, had sought inpatient treatment at the center's facility-based crisis program for heroin addiction.

After being admitted and starting the detox process, the woman began complaining of chest pains and went back and forth between the center and hospital, according to a report by the state Department of Health and Human Services.

She collapsed at the South 17th Street facility on Dec. 27 and died later at the hospital. The original cause of death was listed as heroin overdose. But a pathologist with the state medical examiner's office concluded last month that the woman actually died from pneumonia.

The state pathologist said the examiner who came up with the initial cause of death did not check her heart tissue or run tests for heroin, but made his decision based on reports to him that two heroin packets were found in the woman's room after she was taken to the hospital.

"That's a pretty galloping pneumonia she had there, it didn't happen overnight," the pathologist was reported as saying in an interview to state regulators.

The suspension order, which Southeastern officials said they received Thursday, accuses the facility of neglect for failing to investigate the woman's 17 complaints of neck and back pain in the several days she was there and not communicating effectively with the hospital emergency department's physicians.

It points to the facility's nurses with not reporting the woman's low blood pressure to the on-call physician as required and for giving her a certain medication though a doctor's order said not to if her blood pressure was low.

The 60-page report also faulted Southeastern for not having a set policy of getting patients to and from the hospital emergency department, not providing proper supervision to prevent drugs from being snuck back in while they were at the hospital unattended and not reporting the woman's death properly.

The facility's medical director did not report the death to the state regulators within three days as required because it did not happen there, according to the findings.

Vicki Steele, chief financial officer for Southeastern, said facility officials are currently working on a plan of changes based on the cited violations. The plan will be submitted to the state.

"We are concentrating on the quality of care for the client," she said. "I would say that everything that we are recommending in our plan of correction has that in mind."

The center also can appeal the suspension as well as the penalty. Steele said officials would decide whether to do that once Southeastern's area director returns from vacation.

The facility stopped admitting people late last week and is referring those needing help to either area hospital emergency departments or private mental health providers, depending on the severity of the cases.

The center runs both a 12-bed detoxification center, where most of the violations were recorded by the state, and a crisis station.

The detoxification program can last up to two weeks, but averages about a week for most participants.

When the suspension order came down, the program was full. But only one person remained as of Wednesday to finish up their treatment protocol, center officials said.

The facility's other service, a crisis station, functions somewhat like a psychiatric emergency room, officials said, when someone is threatening to harm themselves or someone else or is going to be involuntarily committed.

Steele said Southeastern is discussing with the state about whether the crisis station's operations should be included in the ruling's suspension.

She said the crisis station sees an average of three to five people a day and as many as 30 a week.

"I'm very sorry this happened because it does affect a lot of citizens in our tri-county (service region)," she said. "We're working very diligently to make sure these clients are cared for.

"I think anytime you have a situation of this type, it's going to have lingering effects, but I'm hoping that we'll be able to get through this process and get through the plan of correction so the services can be restored."